Prostate Artery Embolization
Prostate Artery Embolization (PAE) is a minimally invasive procedure for the treatment of benign prostatic hyperplasia (BPH) with lower urinary tract symptoms (LUTS). Men suffering from urinary frequency, the frequency at night (nocturia), urinary retention, blood in the urine (hematuria), weak stream, difficulty going, and/or starting and stopping urination could potentially benefit from this procedure.
Enlarged prostate or benign prostatic hyperplasia (BPH) is the most common benign neoplasm, or new abnormal growth of tissue in men, with more than 50 percent of men aged 60–69 years and as many as 90 percent aged 70–89 years experiencing symptoms. As life expectancy increases so does the prevalence of BPH.
As a man ages, the prostate gland slowly enlarges and may press on the urethra and cause the flow of urine to be slower and less forceful. An enlarged prostate causes urinary frequency, urgency, passing urine more often, particularly at night (also called nocturia), weakened stream and incomplete bladder emptying. Such symptoms can have significant negative impact on the quality of life, leading many men to seek treatment.
The standard treatment for BPH is surgery, which requires general anesthesia and can cause complications, such as urinary incontinence, sexual dysfunction, impotence and retrograde ejaculation, in which semen enters into the bladder. PAE, which can be performed under light anesthesia, involves a treatment called embolization, which entails temporarily blocking blood flow to the arteries that supply the prostate.
During PAE, an interventional radiologist makes a tiny incision in the groin and advances a small tube called a catheter, to the prostate artery. Microscopic beads are released into the artery, where they lodge and temporarily block blood flow to the prostate, causing it to shrink.
Frequently Asked Questions regarding PAE
How do I know if I am a candidate for PAE?
Our coordinator will send you some forms that you can fill out on the computer and send back via email. The doctor will review the information you provide and, if appropriate, a phone consultation (or in-person, office consultation) will be arranged with you.
Is the procedure covered by my insurance?
Some private insurance companies are covering the procedure. We have an in-office insurance coordinator who will take care of any necessary pre-authorizations or pre-determination letters.
Do I receive anesthesia for the procedure? Is it a painful procedure?
You will receive conscious sedation, IV medications, during the procedure to help keep you relaxed and comfortable. The procedure is not a painful one. We access the vessels that feed the prostate by way of the femoral artery in the groin.
How long is the procedure?
Procedure times do vary from patient to patient, however, on average, most last between 90-120 minutes. You will stay in our recovery area for two hours after the procedure.
Do I need to have a Foley catheter for the procedure?
Can I drive home?
No. You may not drive for 24 hours after the procedure. Someone else can drive you or you may travel by public transportation. If you are coming from out-of-town, we ask that you stay locally the night of the procedure. We consider this safe practice.
Do I need to get blood work or any other pre-procedure tests/exams before my PAE?
This will be determined at the time of your initial consult with the doctor. It is possible that he may ask for blood work or a special CT scan prior to moving forward with the PAE.
Are the embolization particles permanent?
Yes, the particles are permanent.
Do the particles move? Ever go somewhere unintended?
With our doctor’s expertise and extreme attention to detail, the particles are only delivered to their intended target arteries. Once delivered, the particles do not move.
Are there additional charges for follow-ups?
No. All follow-ups are included.
When can I return to work/physical activity/sexual intercourse?
Avoid strenuous activity, such as climbing long flights of stairs, for 24 hours after your procedure. No
heavy lifting (greater than 10-20 lbs) for a week, or until the puncture site heels. Upon resuming sexual intercourse, be aware that you may see blood in your ejaculate for 7-21 days.